Loneliness Could Increase Paranoia, Study Suggests

Posted on: July 28, 2016/

Lonliness could be a cause of paranoia, and reducing loneliness could significantly decrease paranoid beliefs, a study published online in theJournal of Behavior Therapy and Experimental Psychiatry shows.

A team of German researchers manipulated perceived levels of loneliness in a sample of 60 healthy participants, and measured the changes in their state of paranoia. Participants’ overall proneness to psychosis was also considered.

MORE: Adjunctive Cognitive Behavioral Therapy Could Help Stave off Psychosis

“Loneliness is a common problem in patients with schizophrenia, and may be particularly linked with persecutory ideation,” the authors wrote. “Nevertheless, its role as a potential risk factor in the formation and maintenance of persecutory delusions is largely unexplored.”

Induction of loneliness lead to more pronounced paranoia overall, and a decrease in loneliness was associated with a significant reduction in present paranoid beliefs, the team found.

In addition, “proneness to psychosis significantly moderated the impact of loneliness on paranoia,” the authors wrote.

“Persons with a pronounced level of proneness to psychosis showed a stronger reduction of paranoid beliefs as a consequence of a decrease in loneliness, than less prone individuals,” the study says.

The team recommended research in high-risk individuals on the association between loneliness and paranoia, and the possible implications for cognitive behavioral therapy.

– Terri Airov

Reference

Lamster F, Nittel C, Rief W, Mehl S, Lincoln T. The impact of loneliness on paranoia: An experimental approach. Journal of Behavior Therapy and Experimental Psychiatry . 2016 June 21;[Epub ahead of print].

مجنون الفكرة في العيادة النفسية

أحداث جسيمة مرت على البشرية في الفترة الأخيرة من جرائم و خراب وقتل و يعزي أن منفذها ليس سليم العقل بل هو مجنون

منهم من زار العيادة النفسية من قبل و خضع لعلاج دوائي و له ملف مريض نفسي سابق بأحد العيادات أو المستشفيات و منهم من لم يزر عيادة نفسية و لكنه اقترف فعل لا يخضع للمنطق و العقل و تشوبه عدم الرتابة لا في القول ولا في الناتج و يخلوا من دافع سوي

نتذكر طيارة مصر للطيران و المشهورة باسم طيارة البطوطي 1999 و التى سقطت بالمحيط و محطمة في أجزاء و في الوقت الذي ادعت فيه السلطات الأمريكية ان قائد الطائرة كان مريضا نفسيا و انها محاولة انتحار ناجحة و تضاربت الردود السياسية ان البطوطي كان متوازن العقل و لا يمكن أن يقترف مثل هذا الفعل و انه حطمت من قبل العسكرية الأمريكية .. بتخطيط من الموساد حيث انها كانت على متنها قرابة 35 طيار مصري حربي

ولكنهم أشاعوا و أكدوا أن البطوطي كان مريضا نفسيا و انها كانت انتحارا مؤكدا منه بدليل انه قال فوضت أمري الى الله أكثر من مرة ( قرابة 14 مرة) كما ظهر في الصندوق الأسود و خرجت الأفلام الوثائقية الممثلة ببراعة تؤكد انه يعاني من اضطراب و جداني و انه كان في حالة اكتئاب ولكنه ظهر في فيلم الناشيونال جوجرافيك الوثائقي انه كا في حالة هوس قبيل رحلة الطيران و انه أفرط في الشراب ولكن لم تتقبل الجهات المصرية هذا التفسير و و انتهت بنظرية المؤامرة .. وطار بعدها مباشرة مبارك الى باريس حيث انه كانت هنا معاهدة و اتفاقية بين الاستخبارات المصرية و الاسرائيلية بوقف الاغتيالات بضمان من فرنسا و لم تظهر اية بيانات أخرى بعدها و تم التكتم على من مات من رجالنا و ساد الصمت

و يبقى لنا سؤال لم نجيب عنه .. هل كان البطوطي مريضا نفسيا؟؟

وفي ظروف أخرى حديثة تكررت

نفس الحادثة و تأكدت على مساعد الطيار الألماني الذي أغلق كابينة القيادة عليه حينما ذهب الكابتن للحمام و هوى بالطائرة فوق جبال الألب و أكدت السلطات الألمانية انه كان مريض اكتئاب ذهاني و يخضع للعلاج الدوائي الغير موفق و انه قاد الطائرة بما عليها من ركاب الى الموت ..حيث أغلق كابينة القيادة من الداخل و قت خروج الطيار الأساسي لدورة المياه و نفذ انتحاره و قتل الرحمة لركاب الطائرة كما يرى.و كان منذ قبل أسبوعين فقط يزور طبيبته النفسية و التي كانت متشككة في سلامته و قدرته على العمل و لكنه و عد بالالتزام بالعلاج الدوائي

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أذكر في يوم لي في طوارئ الصحة النفسية بأحد الدول العربية بالخليج منذ قرابة العشرين عاما حضر شاب لقسم الطوارئ و طلب المقابلة و كان الوقت أثناء تبديل طاقم اطباء الطوارئ النفسية .. و كان هادئا تماما و ليس لديه ملف سابق للعلاج و لم يسبق أن قابل أي طبيب من قبل و قال انه يشعر بالضيق من حياته و يبلغ عليه السأم ولا يريد العلاج و لكنه ينوي قتل زوجته ..أخفيت دهشتي و تمت المقابلة و طال الوقت و لم يكن هناك أي شئ غير طبيعي يشير الى اضطراب نفسي جسيم .. هدأت من روعه أو هكذا تصورت و طلبت منه الحضور للعيادة الخارجية ف الغد أو قبول التنويم بالمستشفى تحت الملاحظة.. رفض أي من الحلول و قال لا و بدأ يظهر اشارات غريبة بعينيه و كأنها مفتعلة ..عموما صممت على دخولة المستشفى تحت الملاحظة ولم يكن هناك أي شخص قريب أو مرافق له يمكن الحديث معه و قال سيحاول أن يزورني بالعيادة الخارجية في صباح اليوم التالي

مر اليوم هادئا و أكاد ان أكون نسيت الموضوع

في صباح اليوم الثالث وجدت مجموعة من الشباب يبحثون عني بالاسم في المستشفى ووصلوا لي وسألوني هل جاء لك فلان بالطوارئ قبل أمس ..

قلت : نعم

:وهل ووصفت له علاج مؤقت و طلبت منه القدوم للعيادة النفسية …

قلت : نعم

قالوا : لي حسنا انه قتل زوجته قبل أمس .. و نحن نريد الآن تقرير طبي أنه مريض و انه غير مسؤول!!!

هكذا بهذه السرعة و الاريحية .. كان وقع الخبر صادما علي و تصنعت عدم الدهشة ولكن

انتابني شعور بالعجز و الخوف و الجهل بالعلم و عجز الطب النفسي كعلم و فشله في التمييز هل هذا كان مجنونا أم انه مدعيا و هل انا تقاعست في رد الفعل المفروض اتخاذه نحو هذا الشاب الذي ربما كان مريضا

على غرار هذا المريض رأيت العديد من المرضى ..ليس بالضرورة يزعم قتل أو أذى و لكنه يتبنى فكرة غاية في الغرابة

ولم تستوفى حالته شروط المرض النفسي المتكامل .. و أنا أعلم انه يوجد مريض يستطيع اخفاء أعراضه ببراعة و يستطيع تصنع الطلاقة في عدم اظهار الفكرة المرضية.

و مريض آخر كان يعمل في مهنة مرموقة و يستطيع ادارة أمواله والتي كانت أكثر من عشرة ملايين من الجنيهات و يتواجد في ثلالة أماكن عمل في نفس الأسبوع ليدير عمله بنجاح و يتقدم في عمله وأبحاثه و مثقف جدا و ….ولكنه في الوقت ذاته كان يميل للعزلة ..ملابسه غير متناسبة مع عمله ، فيهمل في هيئته و مظهرة و أحيانا يميل الى غلق الزر الأخير في قميصة و يكاد يخنق رقبته و لا يقبل المزاح أو يستشعر الدعابة اذا مازحته بخصوص هذا الشئ.. ومن حين لآخر يستقر بؤبؤ عينيه في الركن وتتوقف كشئ من التحدي أو الشك و الترقب ، و أحيانا أخرى تتغير الهيئة بلا رتابة مطلقا .. و برغم ثراءه الا انه لا يغير ملابسه .. و يحضر با نتظام في موعد عيادته لمقابلتي ويطلب المقابلة و ينفي عن نفسه أي مرض نفسي ..و يجادل على العلاج الدوائي… و يصرح بفكرة غاية في الغرابة كثيرا ما نسمعها من مرضى الفصام مع أعراض أخرى .. و لكنه لا يقول غيرها و هي انه يشعر بالتنمل بالشرج و احيانا بالاتساع اذا مر في تجمعات بها العديد من الرجال.. أعرف أن سيجموند فرويد وصف حالة المريض شريبر الفصامية وفسر على أساسها انه يعاني من جنسية مثلية مستترة و انه يقوم بعمل اسقاط على الاخرين ثم ينكر ذلك على نفسه فيتحول الفكرة الى الضد .. انهم يضطهدونه ..و ربما يراقبونه .. و يشعر بأحاسيس تتناسب مع الموقف الذي لا يتحمله .. و لكن لغرابة الفكرة الوحيدة التي يعيش فيها هذا المريض الذي أسلفنا قصته كنت أضغط عليه بشدة و لين لعدم التوقف عن جرعة دوائية صغيرة و كان يجادل فيها جدالا شديدا و للغرابة لا يتوقف من نفسه عنها و يتوقف عن زيارتي و في نفس الوقت لم أرى له قريب أو صديق يمكن أن يساعدني و يشترك في الضغط عليه للموافقة للالتزام بالعلاج .. و مر عام لم أراه فيه و لم تأتي لي أي أخبار عنه لأتلقى صفعة قاسية بأنه قتل ببشاعة رجل مشارك له في البيزنس الخاص به .. وغرابة قصة القتل بلا أي دافع ملموس ..و ظهرت نظرات عينيه الشاردة و انه ينكر ما فعل و الذي يصفه و كأنه حلم و لكن ليس بالقتل و ليس بانسان!! بل كان فأرا للتجارب

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وعلى مستوى العالمية ظهرت قضايا في العلن لم تختفي في عيادة النفسية و لم يستطع الطبيب النفسي من التستر .. ففي العشرين من يوليو عام 2010 أي في نفس يوم هبوط الانسان على سطح القمر …في نفس يوم عيد العقل البشري الذي غزا الفضاء وخطا فوق القمر …العقل الذي تحدث و تكلم بعد ما تعلم الأسماء كلها و اشتق منها أسماء وأفعال ..كان هناك جانب مظلم من العقل البشري

خرج جيمس هولمز في كولورادوا بعد ما صبغ شعره بالاحمر و حمل سلاحا و دخل دار سينما و أثناء عرض فيلم باتمان عاث بسلاحه قصفا للحاضرين ليسقط 12 قتيلا و أكثر من خمسين جريحا

و شهد كثير من الجيران على غرابة أطوار هذا الشاب جيمس هولمز الذي كان يقطن و حده ..هذا الشاب الوسيم والذي تخرج من قسم الميكروبيولوجي بجامعة سان دييجو .. كان غريب في خطواته و سيره و بداية حدثه و نهايته و كان يتحاشاه الكثير من الجيران و لكنه قتل . ..و بفكر شارد و بدون هدف أو وعي و لم يكن تحت تأثير عقاقير و لكن قال انه توحد مع شخصية الجوكر المقابل لباتمان في أعمال الشر و رأى في لحظة يأس ان الجوكر يقضى على هذا المجتمع .. ولم يستطع الأطباء اثبات المرض النفسي عليه الذي يعفيه من المسؤولية

http://www.telegraph.co.uk/news/2016/06/14/orlando-gunman-was-a-regular-at-lgbt-nightclub-pulse-before-atta/

في يونيو 2016 دخل عمر متين – المولود بأمريكا – الشاب الشاذ جنسيا أو المرح كما يلقبوا انفسهم ملهى مخصوص للشواذ و قام بعملية قتل جماعي في أسوأ حادث قتل جماعي بالولايات المتحدة الأمريكية ليصرع خمسين من رواد الملهى بأورلاندو الى ان اتخذ رهائن و تم فض المأزق بقتله و تحرير الرهائن.. وفي الوقت الذي قالت فيه بعض الأنباء انه شاذ جنسيا و انتقم من صاحبه الذي تركه ترددت أنباء عن انه ينتمي للقاعدة و أخرى انه ينتمي لداعش أي فكرة كان يتبناها عمر ليسحق نادي الشواذ باصرار .. ماذا كان يدور بعلقه .. لوط عليه السلام لم يقرر هذا الطريق و لم يقتل أحد من أبناء قريته سرا و با علانية و كان فقط يهديهم و يناشد العقل و الرشد فيهم ” أليس منكم رجل رشيد” وجاء أمر الله بملائكته بلاخروج و ليس بالقتل و لكن لم يأتي له مباشرة .. وكأن الدمار قرار الهي كشق البحر و الطوفان ..هل كان ذلك عجز و فشل سياسي أو كان عجز اجتماعي ..غير معروف عن عمر متين اذا كان تردد على أحد الأطباء النفسيين أم لا .. و ربما اذا كان تردد فلا علاقة لجريمته و مرضه النفسي ..غير اننا لا نملك بالطب النفسي آليه حاسمة تتنبأ بقتل أو اجرام محتمل

Worst US mass shootings in last 25 years

At least 50 dead, 2016 – Omar Mateen opens fire on revellers at gay club in Orlando, Florida
32 dead, 2007 – Student Seung-Hui Cho massacres students at Virginia Tech university before killing himself
27 dead, 2012 – Adam Lanza kills 20 six- and seven-year-old children and six adults before killing himself at Sandy Hook, Connecticut
23 dead, 1991 – George Hennard drives through the wall of a cafe in Killeen, Texas, before opening fire and committing suicide
14 dead, 2015 – Syed Rizwan Farook and Tashfeen Malik open fire at a staff gathering in San Bernardino
13 dead, 2009 – Maj Nidal Malik Hasan opens fire at army base in Fort Hood, Texas
13 dead, 2009 – Jiverly Wong shoots people at New York immigrant centre before killing himself
13 dead, 1999 – Eric Harris and Dylan Klebold kill fellow students and a teacher at Columbine High School in Littleton, Colorado

و الأمر لا يقف عند هذا الحد

يأتي للعيادة النفسية مريض يتبنى فكرة تكون غاية في البلاهة و الغرابة فمثلا من الأفكار الشائعة التى كثير ما تتردد بالعيادة أن عينيه تحيد دون ارادته و تستقر عند الأعضاء التناسلية لدى الآخرين و انه على هذا الحال منذ عشر سنوات أو يزيد و يجزم بحدوث ذلك و ان هذا الموضوع تسبب في حرج شديد له لأن الناس تطالعه بريبة من جراء ما يفعل و أن أزواج السيدات في الأسواق يتابعونه و قد ينتقمون منه أو الرجال انفسهم يتململون حينما تتثبت عينيه على أعضائهم .. و يؤكد لك انه لم يحدث مرة واحدة ان ناقشه أحد في الأمر و لكنها حقيقة و ليست أوهاما

و يأتي للعيادة النفسية و يبقل العلاج و الدواء و تتحسن حالته و لكن يا ترى كم لديه هذا الشعور و الفكر المريض و لا ياتي للعيادة النفسية

و هناك أفكار أخرى قد تكون بيئيا و ثقافيا مقبولة نوعا ما بأن الشخص مسحور أو محسود أو أحدهم بلغ مبلغا من التأثير المباشر عليه .. ستقول و ما في ذلك ؟؟ لا ذا المريض لا يأتي العيادة النفسية و لكن من يأتي باع الأرض و البيت للتخلص من السحر و منع زواج أبنائه وبناته لأنهم مسحورين و محسودين ولم يتبقى من أموال لديه نفقها طوال عشرات السنوات للتخلص من السحر الذي أصابه و أحيانا يتربص بأناس مارة من قبل البيت للتنكل بهم و ضربهم و كثير ما تحدث حوادث جسيمة فيها موت و قتل و ورائها فكرة سحر و عين و ترى فتاة شابة أنيقة مهندمة تتدعي الليبرالية و الثقافة و لكنها تضع ملابسها في الماء المالح لأيام للتخلص من السحر العالق بها وتهدد الأهل لو لم يكفوا عن سحرهم لها هم و جيرانها ستؤذيهم و أخرى حرقت الملابي و ثالث حرق الستائر والسجاد و رابع حطم نجف البيت لما فيها من كريستالات بلورية تضخم الأعنال السحرية و هكذا تنتابهم نوبات من العنف الشديد و الهياج و البكاء و الصراخ في محاولة لتفسير ما يشعرون به و يصدقونه

وقد يجد من أفراد الأسرة من يشارك هذا الاعتقاد فاذا كان فقط اثنين ….

Folie a deux يعتقدان بالفكرة الغير منطقية

يطلق عليها

أو ضلالا الاثنين ولو ثلاثة يطلق عليها Folie a trois أو ضلال الثلاثة

أما اذا كانت الأسرة مجتمعة في نفس الاعتقاد فهم Folie a famie أوضلال و وهام الأسرة

و الأمر أكثر من ذلك حينما يشترك مجموعة من الناس

مجموعة من الناس تتبنى فكرة معينة انها الطائفة cult

و ماذا يعني اعتقاد الطوائف

في الولايات المتحدة الأمريكية أكثر من 2000 طائفة كل منها تحمل اعتقادا و تتبناه و ترعاه و قد تتخذ سبيلا في تطبييقه

غالبا ما يكون لهذه الطائفة راعي أو مؤسس و يملك قدرة و ملكة اقناع للبعض الذين بدورهم يضمدون جراح نفسيه لديهم بترسيخ هذه المفاهيم و تكون حزمة الأفكار وراء بؤس و شقاء العديد منهم و لكنه جنون الابداع أو ابدا الجنون

أَصْحَابَ السَّبْتِ

قال تعالى في سورة “النساء”:

” أَوْ نَلْعَنَهُمْ كَمَا لَعَنَّا أَصْحَابَ السَّبْتِ وَكَانَ أَمْرُ اللَّهِ مَفْعُولًا”

القصة:

أبطال هذه الحادثة، جماعة من اليهود، كانوا يسكنون في قرية ساحلية. اختلف المفسّرون في اسمها، ودار حولها جدل كثير. أما القرآن الكريم، فلا يذكر الاسم ويكتفي بعرض القصة لأخذ العبرة منها.

وكان اليهود لا يعملون يوم السبت، وإنما يتفرغون فيه لعبادة الله. فقد فرض الله عليهم عدم الانشغال بأمور الدنيا يوم السبت بعد أن طلبوا منه سبحانه أن يخصص لهم يوما للراحة والعبادة، لا عمل فيه سوى التقرب لله بأنواع العبادة المختلفة.

وجرت سنّة الله في خلقه. وحان موعد الاختبار والابتلاء. اختبار لمدى صبرهم واتباعهم لشرع الله. وابتلاء يخرجون بعده أقوى عزما، وأشد إرادة. تتربى نفوسهم فيه على ترك الجشع والطمع، والصمود أمام المغريات.

لقد ابتلاهم الله عز وجل، بأن جعل الحيتان تأتي يوم السبت للساحل، وتتراءى لأهل القرية، بحيث يسهل صيدها. ثم تبتعد بقية أيام الأسبوع. فانهارت عزائم فرقة من القوم، واحتالوا الحيل –على شيمة اليهود- وبدوا بالصيد يوم السبت. لم يصطادوا السمك مباشرة، وإنما أقاموا الحواجز والحفر، فإذا قدمت الحيتان حاوطوها يوم السبت، ثم اصطادوها يوم الأحد. كان هذا الاحتيال بمثابة صيد، وهو محرّم عليهم.

فانقسم أهل القرية لثلاث فرق. فرقة عاصية، تصطاد بالحيلة. وفرقة لا تعصي الله، وتقف موقفا إيجابيا مما يحدث، فتأمر بالمعروف وتنهى عن المكر، وتحذّر المخالفين من غضب الله. وفرقة ثالثة، سلبية، لا تعصي الله لكنها لا تنهى عن المكر.

وكانت الفرقة الثالثة، تتجادل مع الفرقة الناهية عن المنكر وتقول لهم: ما فائدة نصحكم لهؤلاء العصاة؟ إنهم لن يتوفقوا عن احتيالهم، وسيصبهم من الله عذاب أليم بسبب أفعالهم. فلا جدة من تحذيرهم بعدما كتب الله عليهم الهلاك لانتهاكهم حرماته.

وبصرامة المؤمن الذي يعرف واجباته، كان الناهون عن المكر يجيبون: إننا نقوم بواجبنا في الأمر بالمعروف وإنكار المنكر، لنرضي الله سبحانه، ولا تكون علينا حجة يوم القيامة. وربما تفيد هذه الكلمات، فيعودون إلى رشدهم، ويتركون عصيانهم.

بعدما استكبر العصاة المحتالوا، ولم تجد كلمات المؤمنين نفعا معهم، جاء أمر الله، وحل بالعصاة العذاب. لقد عذّب الله العصاة وأنجى الآمرين بالمعروف والناهين عن المنكر. أما الفرقة الثالثة، التي لم تعص الله لكنها لم تنه عن المكر، فقد سكت النصّ القرآني عنها. يقول سيّد قطب رحمه الله: “ربما تهوينا لشأنها -وإن كانت لم تؤخذ بالعذاب- إذ أنها قعدت عن الإنكار الإيجابي, ووقفت عند حدود الإنكار السلبي. فاستحقت الإهمال وإن لم تستحق العذاب” (في ظلال القرآن).

لقد كان العذاب شديدا. لقد مسخهم الله، وحوّلهم لقردة عقابا لهم لإمعانهم في المعصية.

وتحكي بعض الروايات أن الناهون أصبحوا ذات يوم في مجالسهم ولم يخرج من المعتدين أحد. فتعجبوا وذهبوا لينظرون ما الأمر. فوجودا المعتدين وقد أصبحوا قردة. فعرفت القردة أنسابها من الإنس, ولم تعرف الإنس أنسابهم من القردة;

New Brain Map Charts Fresh Territory

Megan Brooks
July 21, 2016

A team of neuroscientists has charted the most complex and precise map of the human cerebral cortex to date, and it has revealed almost 100 new regions. These findings will provide a greater understanding, as well as advance the study, of brain disorders such as autism, schizophrenia, dementia, and epilepsy.

The map, dubbed Human Connectome Project Multi-Modal Parcellation version 1.0 (HCP-MMP1.0), divides each hemisphere of the brain into 180 distinct cortical regions; of these, 97 have never been described before.

The report was published online July 20 in Nature.

Imaging Data

The team, led by Matthew Glasser, PhD, and David Van Essen, PhD, of Washington University School of Medicine, in St Louis, Missouri, created the map using imaging data from 210 healthy young adults from the Human Connectome Project.

They combined several brain mapping techniques that have previously been used only separately, namely, task-based functional MRI (fMRI), which yields information on the functions of different regions; resting-state fMRI, which details neural connectivity within and between different regions; and relative density of the neuron-sheathing substance myelin, which provides data about cortical architecture.

A 180-area multimodal human cortical parcellation on the left and right hemisphere surfaces. (Credit: Matthew F. Glasser, David C. Van Essen)
“We used multiple measures of the organization of the cerebral cortex,” Dr Glasser told Medscape Medical News. “We looked at microstructural architecture, function, connectivity, and topographic maps. We focused on those locations where these maps changed in multiple independent measures, giving us more confidence in these areal boundaries,” he explained.

Next, the researchers trained a machine learning algorithm to recognize each cortical area on the basis of its multimodal “fingerprint” ― that is, its pattern of architecture, function, connectivity, and topographic maps, Dr Glasser said.

Despite individual variability, this algorithm successfully found these areas in an independent group of 210 study participants who were not part of the original parcellation or of the algorithm training.

First Application

Dr Glasser said the first application will be in brain imaging research. The map will help investigators know where they are in the cerebral cortex when they conduct a study.

“That will make it easier for them to compare with a colleague’s separate study to see if they found the same brain area activated, neighboring brain areas activated, or the activations were further away,” he said.

In the past, it was not always clear whether the results from two neuroimaging studies related to the same area or not. By using the new map and alignment algorithm, results of separate studies can be more accurately compared, he explained.

Individualized brain maps may also help neurosurgeons avoid damaging important parts of the brain, such as those that control movement or speech, Dr Glasser said.

“We were able to persuade Nature to put online almost 200 extra pages of detailed information on each of the 180 regions as well as all of the algorithms we used to align the brains and create the map,” Dr Van Essen commented in a news release. “We think it will serve the scientific community best if they can dive down and get these maps onto their computer screens and explore as they see fit.”

Springboard for Discovery

“These new insights and tools should help to explain how our cortex evolved and the roles of its specialized areas in health and disease, and could eventually hold promise for unprecedented precision in brain surgery and clinical workups,” Bruce Cuthbert, PhD, acting director of the National Institute of Mental Health, which cofunded the research as part of the Human Connectome Project, said in a statement.

“An authoritative map of the modules that make up the cerebral cortex of the human brain promises to act as a springboard for greater understanding of brain function and disease,” write B. T. Thomas Yeo, PhD, of the National University of Singapore, and Simon Eickhoff, MD, PhD, Heinrich-Heine University, Dusseldorf, Germany, in an accompanying editorial.

“This long-awaited advance provides a reference atlas that will allow those researching brain structure, function and connectivity to work within a common, systems-neuroscience framework.

“It is now up to researchers to use the anatomical framework provided, compare it with alternative approaches to mapping the human brain, and populate the defined areas with functional and disease related information,” they write. “By doing so, we can begin to integrate multimodal data to understand how individual differences in brain organization can explain differences in function, behaviour and disorder.”

Dr Yeo and Dr Eickhoff note, however, that the authors’ validation of this algorithm focused on only a small portion of the cortex, so further investigation is crucial.

“Nevertheless, their work represents a major step towards individual-specific ‘biomarkers’ of brain dysfunction, because individual-specific quantities of each area, such as grey-matter volume or connectional strength to other areas, can now be computed, and could be strongly predictive of individual differences in behaviour or disease,” they write.

Nature. Published online July 20, 2016. Abstract, Editorial

The Power of Suggestion

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Learning system online – Benefits!

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learning

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virtual reality – can be used for elearning

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هل نقص فيتامين ب12 هو السبب؟

كل ما تقدم بك العمر تقل قدرة جسمك على امتصاص فيتامين ب 12 أو تبطأ أو تتناقص – و لكنه ليس تقدم العمر وحده

أيضا عدم تناول اللحوم الصحية

تناول بعض الأدوية مثل عقار الجلوكوفاج و عقاقير الحموضة و مختلف حبوب المعدة

جراحات المعدة بكل أشكالها

الريجيم

كل هذه سيدخلك في مشاعر مختلفة و أعراض مرضية قد تختلط مع أمراض أخرى و هي وليس هذا فحسب بل ستشعرك بالاعياء و عدم التركيز

هل يلازمك شعور بالعياء و التعب والنعاس

هل ترى اختفاء الحيوية و النشاط منك و يلازمك شعور والميل للنعاس و الارهاق مع انك حصلت على كفايتك من النوم ..فجسمك يعتد على كرات الدم الحمراء و التي بدورها تحمل الاكسجية المطلوبو النتيجة ستشعر باعياء مستمر و ارهاق دائم

لا تستطيع حمل كيس خفيف

نعم أو حتى حقيبة اليد أو أكياس البقالة و ستسأل من يساعدك و تتعجب لقد كنت تحملها قبل ذلك

انه جزء من منظومة الوهن و التعب الجسماني العام ويظهر معك بهذا الشكل

تنمل بالاطراف

أو لسعات كهرباء أو تنمل كأنك كنت نائما على قدمك و على ذراعيك و لكنه مستمر ولا ينتهي بالاعتدال ..احساس ثقيل الظل

أين أشيائي

أين وضعت المفاتيح كانت بيدي .. لا أجد نظاراتي ..انها رابع نظارة تضيع مني..لا تقلق انها ليست أعراض الزهيمر .. فمريض الزهيمر ينكر نسيانه

و لكن راجع نفسك اذا لا حظت ضياع أوراقك أو انك تأخذ وقتا في البحث عنها

دوخة

ربما كان من اكثر الأعراض شيوعا في العيادة النفسية و العصبية .. شعور بعدم التوازن كثير البحوث أكدت هذا العرض يصاحب نقص فيتامين ب 12

شحوب الجلد و البشرة

لم يعد و جهك الوردي اللون ولا الشفتان الورديتان بل الباهته ..نعم فكرات الدم الحمراء سريعا ما تتكسر لديك و تنساب صبغة الببيليروبين الداكنة و المصفرة لتسهم في شحوب الجلد

لسان أحمر و أملس

نعم الغدد الحلمية على سطح اللسان و أطرافه و التي هي مضخات و تحوي على خلايا التذوق و تمنح القدرة على تمييز الأطعمة ستشعر بفقد هذا الاحساس تمهل و تذوق و اذا عجزت ففكر في فيتامين ب 12

هش و سهل البكاء و التأثر

حتى مع مواقف بسيطة ستجد دموعك سباقة و سريع التعاطف و أيضا تعرضك لنوبات اكتئاب أو قلق .. أتعرف لماذا لأن فيتامين ب12 مسؤول …ان كيمياء المخ تتكامل و تعمل بجد في وجود فيتامين ب 12انه مسؤول عن مصنع النواقل العصبية بالمخ كالسيروتونين و الدوبامين و الادرنالين و هم وراء اضطرابات نفسية عديدة و تعرض صاحبها لنوبات من القلق و الاكتئاب و المخاوف القهرية

حتى زغللة العين

هل تبذل مجهود لرؤية و اضحة هل تتزاحم الحروف و تتداخل و تمل في النهاية و تلقي بالاوراق جانبا .نعم شبكية العين و مجال الرؤية تتكامل وظائفهما في وجود فائض من فيتامين ب 12

لا يوجد مبالغة .. طعامنا غير صحي و فيتامين ب12 يتناقص أما فيتامين د…. لنا معه وقفة أخرى قريبة

Writing Our Lives as Fiction

by Leslie Durr, PhD

In an effort once again to avoid sitting down to write, I decided to watch a DVD on “Writing Great Fiction,” a presentation from The Great Courses that I purchased a while ago, because isn’t there at least one novel in each of us? The lecture was interesting and was working perfectly as the distractor I’d hoped for until the lecturer began to say that good fiction is about characters trapped in situations not of their own making which force them to deal with the situations as best they can.

He said that fiction usually begins in the middle of things, and differentiated “story,” which is the chronological listing of events, from “plot,” which is the story plus causality and motivation. He went on to say that writers bring meaning out of meaninglessness. They make order out of chaos. They select facts and order those facts a certain way.

I realized that is exactly the way we live our own lives and that lies at the heart of narrative psychology. And suddenly I was back to writing a blog entry, although not the one I had planned.

Freud wrote about dream narratives; Jung about universal life myths. But neither they nor any classic theorists from the early part of the 20^th century imagined people as storytellers and their lives as stories to be told. In the past 20 years or so a number of psychologists have suggested that the elements of personal narrative are important in understanding personality and also as a focus of psychotherapy.

How do we develop the stories of our lives?

Viewing one’s life as storytelling is by definition a retrospective activity. Even though we may tell a chronological story, we do so through the eyes of the individual we are at that moment. So, how did we get to this moment in order to tell the story just this way? What influences shape today’s “me?”

First, our parents tell us a story: whether the world is basically good or bad and how to act in either circumstance; whether we should trust anyone or have loyalty to anyone outside the family; whether we’re lucky or unlucky. We hear what kind of person we are: “you’re just like …;” “oh, you’re such a (scaredy-cat, adventurer, bookworm, athlete, genius, etc.);” “you’re (a sneak, a thief, a good girl, totally special).” They alert us as children about what things to pay attention to – either good or bad – and encourage us to ignore the other things. That’s the beginning of our personal GPS, as it were, which may be why people seem so comfortable having a disembodied voice saying, “Recalculating. Turn left in 100 yards.”

But that story isn’t written on the child as a tabula rasa. There is an intersection of the family story with the inborn temperament of the child. Any parent of more than one child will tell you that each child was different from day one or even before birth. One of my 2 children tap-danced and kicked my ribs frequently during pregnancy while the other one was more modest in activity. And that characteristic held true in childhood and even now that they are adults.

Starting in 1956 and continuing over several decades, Alexander Thomas, MD, and Stella Chess, MD, studied a cohort of children from birth, including direct observation and interviews with parents (the New York Longitudinal Study.) The team came up with nine separate “qualities” associated with personality and temperament that were present from birth and rather stable over time. These traits were:

Activity level
Regularity or rhythmicity
Initial reaction, also known as approach/withdrawal
Adaptability to new things
Intensity – the energy level of a negative or positive reaction
Mood
Distractibility or focus
Persistence and attention span especially through frustrations
Sensitivity, also known as sensory threshold.

Thomas and Chess found that not only did the parents influence the child, but the child’s temperament traits affected and influenced the parents. This was most apparent in the instances when there was a major mismatch between parental and child temperaments and the parent(s) reacted with antagonism or anxiety. In general, the study found that even with a mismatch of temperaments, if there was congruence of a child’s behavior with the parent’s “goals, standards and values,” the nature of the parents’ response was more positive.

So, the quiet, shy child born to a family that likes to roughhouse and play touch football, hears that he isn’t fitting in and develops a life story of not-good-enough and expecting the world to be critical. The child with a high activity level and intense reactions to events, born to quiet academic parents, also hears a story that sets her up to feel like a misfit in social situations. The child with the good enough fit with her parents’ temperaments and expectations still absorbs story lines from parental admonitions and from watching her parents interact with the world, and begins to weave her own story of her life.

Dan P. McAdams, PhD, a professor of psychology at Northwestern University and author of the 2006 book The Redemptive Selfformulated a “life-story model of identity” which held that by adolescence, we begin to understand our lives as evolving stories that incorporate the parental stories into our own narrative. He theorized that we are continually updating a treatment of our own life — and the way in which we visualize each scene not only shapes how we think about ourselves, but how we behave. If we can come to understand how our life stories are built, we may be able to alter our own narrative, in small ways and perhaps large ones.

Isn’t helping patients revise their life story what therapy is all about?

References

McAdams,

DP. “The role of narrative in personality psychology today.” Narrative Inquiry.

2006;16(1):11-18.

Distracted by Multitasking? Try Mindfulness

Sean’s coworkers used to be impressed with how he could scan through sales data and compose an email message while talking on the phone about an ad campaign with someone from marketing. They wondered if multitasking could help them get more work done. Then, they noticed Sean didn’t hit his performance goals.

Are multitasking pros more productive than the rest of us?

No.

That’s the answer from Clifford Nass’s research at Stanford. In 2009, Nass and his colleagues found that multitasking reduces our ability to concentrate. That was bad news for all of us who spend our days barraged with information.

Good News: Ten Minutes Makes a Difference

Now, recent research has an antidote: Just ten minute sessions of mindfulness of breath, three times a day, reverses the degradation in concentration common in media multitaskers. Thomas E. Gorman & C. Shawn Green, researchers at the University of Wisconsin-Madison, found that multitaskers perform better after completing a short meditation exercise in which they sat quietly counting their breaths.

Gorman and Green’s research shows, again, what I’ve known for years: training attention pays off in practical ways. Mindfulness is the basic move of noticing your mind has wandered and bringing it back into focus. And, just like building muscles by repeating exercises at the gym, you can build the “attention muscles” in your brain through the practice of mindfulness.

Applied Self-Awareness

Mindfulness is applied self-awareness, the foundation skill in the emotional intelligence model. I have argued that we should help kids strengthen this muscle of mind in schools. It’s the basis for cognitive control – the key to goal focus, ignoring distractions, impulse control, and delay of gratification. These are all core mental skills for learning, leading, and life. Cognitive control has been shown to be a better predictor of financial success when someone is in their mid-30s than childhood IQ or wealth of the family in which they grew up.

In past research, my friend and colleague, Richard Davidson at UW-Madison’s Center for Healthy Minds has shown the benefits of following a guided online mindfulness meditation exercise. Simply counting their breath produced greater self-awareness, less mind wandering, better mood and less distraction.

It’s Not Too Late

Feeling overwhelmed by the flood of information coming at you? This new data on mindfulness and multitasking is good news for us all. It’s never too late to build attention. I’ve been a meditator since my college days, did research on the benefits of meditation while at Harvard, am writing a book about the strong new research on mindfulness and other kinds of meditation, and still meditate daily. I created a series of guided exercises for honing concentration in Cultivating Focus: Techniques for Excellence if you want to give it a try.

Understanding the Law of Opposites

The Law of Opposites states that the path to success requires going against the norm. It requires doing the unpopular, the unreasonable, and the unorthodox. Moreover, it requires being the exception to the rule and not following standard and accepted practices, traditions, and rituals.

The Law of Opposites suggests that the only way you will ever achieve the success you desire to create in your life is to walk a different path to the masses. In other words, it means to do the opposite to the average person — to zig when others zag.

The Law of Opposites challenges you to consistently ask yourself:

What does the majority typically do in this situation?

What results do these people normally get in this situation?

If the answer is less than desirable, then the choice is simple: Choose to do the opposite and possibly you will get the desired results that many fail to realize.

The Law of Opposites is of course just a guideline. It can work in many instances, however it may not work in all situations. As such, common sense must be used in order to properly put this law into practice in your own life.

For the remainder of this article let’s explore the typical choices people make and the behaviors that they normally indulge in that get them very average results in life.

The idea here is that once you become aware of how the average person thinks and lives their life, you can then make a different set of choices using the Law of Opposites to help you live a more optimal, successful and rewarding existence.

Most People Choose Laziness Over Effort

The average person is downright lazy. Wherever possible they will take the easiest road with the least amount of resistance. As a result they don’t grow, they don’t change, and they don’t challenge themselves in new ways.

Whenever we face resistance we grow, which subsequently shapes our character. Moreover, we strengthen our emotional resilience and literally become a better version of ourselves. However, the average person simply doesn’t care enough. Yes, they desire change and the best things that life has to offer, but unfortunately they simply won’t discipline and commit themselves to make the necessary changes. And change of course requires consistent effort, which the average person is simply not willing to give.

Do the Opposite: Commit yourself toward taking consistent daily actions to change your life. Moreover, challenge yourself to go the extra mile to get things done.

Most People Choose to Press the Snooze Button

Laziness for most people begins first thing in the morning when they choose to press that snooze button.

The average person will choose to press the snooze button to get an extra few minutes of broken sleep that does next to nothing for them. It just delays the inevitable and holds them back from getting their day started on the right track.

When they do get up, they do so with distaste. Moreover, they absolutely dread their morning routine. However, for other people who are not average their morning routine is empowering and inspiring. These people make an effort to get their day started in the right way with exercise, meditation, goal setting, and visualization.

Do the Opposite: Get up immediately and jump right into your morning routine with enthusiasm.

Most People Dislike their Job

For the average person getting up first thing in the morning is painful, but it gets worse when they realize it’s not Sunday.

The average person goes to work to make a living, but their career choice does not help them create a life. In fact, they feel like slaves to their job and to their boss. They don’t like going to work and certainly don’t enjoy their morning commute. They will in fact make every excuse in the book to stay at home and make full use of their sick-days. If only everyday was a Sunday. 🙂

Do the Opposite: Find reasons to love your work, or change your career path and focus on something you’re passionate about.

Most People Have Very Little Focus

The average person lacks direction in life. They simply have no focus, no purpose, and no passionate goals that get them out of bed in the morning. That is one of the main reasons why they have a tendency to make lazy choices throughout the day.

The average person just doesn’t live with enough urgency. And without urgency there is a lack of focus and direction. It just feels easy not to make an effort, not to take a chance, and not to make that tough choice. There is simply no motivation, no self-discipline, and no enthusiasm to make positive improvements and changes that could potentially transform their life for the better.

Do the Opposite: Commit yourself to staying focused on your main goals and objectives, and challenge yourself to live with more urgency.

Most People Spend their Spare Time on Mindless Activities

With little focus, the average person is constantly distracted by mundane things. As a result they choose to spend their free time on mindless activities such as watching television, reading the news, surfing the web, or gossiping about other people’s problems and the latest celebrity mishaps.

It could be said that the average person simply doesn’t value their time. They have as much time as everyone else, and yet they choose to spend it on activities that provide them with no long-term gain.

Do the Opposite: Choose to prioritize your time around your most important goals. Then stay focused and productive as you work on them throughout the day.

Most People Live Day-to-Day

The average person lives day-to-day with little regard or thought about the future. Yes, they have hopes and dreams of a better life, someday. However, the choices they make in the present moment are simply not aligned with their long-term vision.

The average person will never achieve their vision because they easily fall prey to instant gratification. They choose fleeting moments of pleasure instead of making the necessary sacrifices to help them fulfil their vision.

The average person lives day-to-day trying to make the most of every moment while at the same time disregarding the future impact of the choices and decisions they make. As a result they rarely commit themselves to long-term development and self-improvement. If something doesn’t give them instant results in the moment, then they will most likely end up choosing something else instead.

Do the Opposite: Develop a plan of action for your life and career success, and commit yourself tobecoming a lifelong learner.

Most People Leave Things for the Last Minute

The average person tries to avoid anything and everything that is distasteful for as long as possible.In other words, they procrastinate and draw things out indefinitely, until the pain of not doing something is more hurtful than simply getting the job done.

With this in mind, it’s easy to see how the average person often leaves things for the last minute. They will of course tell you that they thrive under pressure situations, but the real truth is that they get so caught up and sucked into indulging in fleeting pleasures that they completely mismanage their priorities.

Along the same lines, the average person will often ignore their problems until these problems get completely out of hand. They just hoped things would just go away, but the problem just hung around like a bad smell until it became impossible to ignore.

Do the Opposite: Choose to take massive action to get things done and challenge yourself to tackle your life’s problems early, before they get out of hand.

Most People Shy Away from Responsibility

The average person consistently shies away from responsibility. Responsibility is a burden and requires work. It requires them to commit to something, which obligates them to other people or toward fulfilling certain tasks. And because the average person is lazy, they simply don’t want the burden of extra responsibility on their shoulders.

Beneath the surface though, the average person is petrified of failure and of making mistakes. As such, they tend not to commit to things that are uncertain. With that in mind, they do of course commit at times, but their commitment is weak and filled with hesitation. The moment obstacles arise, they immediately break all their commitments and make a run in the other direction.

Do the Opposite: Challenge yourself to embrace uncertainty and commit yourself to taking responsibility for everything that matters in your life.

Most People Focus on What’s Not Working

The average person is happy and carefree when things are going their way. In fact, they kind of feel unstoppable when the world is conspiring in their favor. However, the moment things go wrong and the world begins to work against them, that is the moment when they break down emotionally and become very erratic and reactive.

Instead of trying to find a solution to their problem, the average person will choose to focus on the negatives of the situation. They will choose to focus on what’s not working and on what can’t be done, instead of taking responsibility for their problem and working toward a solution.

This vicious cycle of focusing on what’s not working keeps them stuck and unable to successfully move through various life challenges they face.

Do the Opposite: Challenge yourself to stay positive, calm and mindful when problems arise. Moreover, develop your emotional intelligence to help you handle difficulties in more optimal ways.

Most People Complain About Everything

When things are not working in their favor, and when their problems get too overwhelming and out of control, the average person will attempt to make themselves feel better by complaining about the situation.

They will complain about what didn’t work, about how others have wronged or mistreated them, about not having enough love, time, happiness, money, respect, and a plethora of other problems and inconveniences.

The average person will complain and talk about their problems all day long to anyone who will listen — all in an attempt to win the sympathy of others. All the while, they do absolutely nothing about their problems. They make no attempt to fix things, or to improve the situation in any way. They instead look to others to help provide them with solutions.

They have problems in the first place because they have made mistakes along the way. However, since they take no responsibility, they simply don’t own up to what happened, and therefore don’t feel obliged to rectify things. What’s worse is that they don’t hold themselves accountable for their choices, decisions and actions. As a result they fail to learn from their experiences and tend to repeat the same mistakes over and over again.

Do the Opposite: Immediately stop complaining and start taking responsibility for your predicament. Also take the time to learn from your experience to help you make better future decisions.

Most People Make Excuses Instead of Progress

If there’s nothing to complain about, then the average person typically indulges in making excuses about why things didn’t go the way they had expected. They will make excuses about their mistakes, results, lack of effort and inability to focus.

Excuses are easy to make. Everyone can make excuses, and as a result most people do. Taking responsibility and making an effort to improve the situation is the path rarely chosen. It’s the path that very few choose to take, and yet it is the path that makes all the difference in the end.

Do the Opposite: Immediately stop making excuses and start thinking in solution-oriented ways to help you work through your problems far more effectively.

Most People Quit When the Going Gets Tough

The average person doesn’t like problems. In fact, they don’t like any form of resistance. Yes, they will pursue certain goals and objectives, however the moment they face a setback, they will very quickly quit (usually after the first attempt) and move onto something else.

Fear, uncertainty and adversity often gets the better of them. But this is of course great news if you’re not average because it means that there is far less competition to worry about as long as you persist and persevere when the going gets tough. 🙂

Do the Opposite: Challenge yourself to persist and persevere, to never give up, and to overcome any setbacks that stand in your way.

Most People Have Very Low Personal Standards

The average person usually quits because they have very low standards and expectations of themselves. They simply don’t expect much and don’t have high enough standards that keep themmotivated and moving forward. It could even be said that most people sell themselves short.

We all have incredible ability and untapped potential. Few people make the most of their potential, while the vast majority simply waste it away.

The average person doesn’t believe that they are destined for greatness. They don’t believe that they are good enough or able to perform at a high enough level consistently over time. These beliefs lay the foundations for their expectations and set the bar for their personal standards. With low standards and subpar expectations, they have very little fuel that keeps them moving forward. As such, it just makes sense to quit once they hit a roadblock.

Do the Opposite: For starters take control of your expectations and commit yourself to raising your personal standards. Expect the very best of yourself and discipline yourself to go after what you want most in life.

Most People Struggle Financially

The average person struggles financially. It’s not because they are unlucky or unfortunate to have been brought up in an underprivileged family. It’s simply because they spend more money than they earn. In other words, they live above their means. They make purchases on credit without having a realistic plan forpaying this debt back.

The vast majority of their lives is spent trying to work their way out of debt. If only they chose to make a different set of choices and decisions. Then just maybe their financial struggles would be a thing of the past.

Do the Opposite: Commit yourself to being more savvy with your financial decisions. Learn more about money and about how to manage your finances more effectively.

Most People Don’t Exercise Regularly

The average person dabbles in exercise. They will try to exercise regularly, but life just kind of gets in the way and ruins their 101st attempt. 😉 Yes they will start over and over again, but with no consistency, they gain very little value and almost nothing to show for their efforts.

Do the Opposite: Self-discipline, commitment and consistency is the key to developing a regular exercise regime that can help you become a healthier version of YOU!

Most People Eat Based on Pleasure Not Health

The average person is very much focused on instant gratification and easily gets drawn into the fleeting pleasures of the moment. As such, they will often choose to eat foods based on the pleasure and satisfaction they gain in the moment rather than on the long-term health benefits of eating that food.

What’s more is that the average person will tend to overindulge on these foods and will often overeat in an attempt to satisfy their tastebuds. And as we know, the average person typically struggles with their weight and as a result finds it more difficult to get into a consistent exercise regime. It’s just a vicious cycle that the average person struggles to break free from.

Do the Opposite: Make dietary choices based on what’s healthy rather than on what’s simply tasty. You could even have the best of both worlds. 🙂

source:

http://blog.iqmatrix.com/law-of-opposites

FDA approves first buprenorphine implant for treatment of opioid dependence

Buprenorphine is a semisynthetic opioid derivative of thebaine. It is a mixed partial agonist opioid receptor modulator that is used to treat opioid addiction in higher dosages, to control moderate acute pain in non-opioid-tolerant individuals in lower dosages and to control moderate chronic pain in even smaller doses.^[3] It is available in a variety of formulations: Cizdol,Subutex, Suboxone, Zubsolv, Bunavail (available as buprenorphine HCl alone or buprenorphine and naloxone HCl (seebuprenorphine/naloxone); typically used for opioid addiction), Temgesic (sublingual tablets for moderate to severe pain),Buprenex (solutions for injection often used for acute pain in primary-care settings), Norspan and Butrans (transdermal preparations used for chronic pain)

Pharmacokinetics[edit]

Buprenorphine is metabolised by the liver, via CYP3A4 (also CYP2C8 seems to be involved) isozymes of the cytochrome P450 enzyme system, into norbuprenorphine (by N-dealkylation). The glucuronidation of buprenorphine is primarily carried out by UGT1A1 and UGT2B7, and that of norbuprenorphine by UGT1A1 and UGT1A3. These glucuronides are then eliminated mainly through excretion into the bile. The elimination half-life of buprenorphine is 20–73 hours (mean 37). Due to the mainly hepatic elimination, there is no risk of accumulation in people with renal impairment.

One of the major active metabolites of buprenorphine is norbuprenorphine, which, contrary to buprenorphine itself, is a full agonist of the MOR, DOR, and ORL-1, and a partial agonist at the KOR.^[59]^[60] However, relative to buprenorphine, norbuprenorphine has extremely little antinociceptive potency (1/50th that of buprenorphine), but markedly depresses respiration (10-fold more than buprenorphine).^[61] This can be explained by very poor brain penetration of norbuprenorphine due to a high affinity of the compound for P-glycoprotein. In contrast to norbuprenorphine, buprenorphine and its glucuronide metabolites are negligibly transported by P-glycoprotein.^[61]

The glucuronides of buprenorphine and norbuprenorphine are also biologically active, and represent major active metabolites of buprenorphine.Buprenorphine-3-glucuronide has affinity for the MOR (K_i = 4.9 pM), DOR (K_i = 270 nM) and ORL-1 (K_i = 36 µM), and no affinity for the KOR. It has a small antinociceptive effect and no effect on respiration. Norbuprenorphine-3-glucuronide has no affinity for the MOR or DOR, but does bind to the KOR (K_i = 300 nM) and ORL-1 (K_i = 18 µM). It has a sedative effect but no effect on respiration.

Expanded use and availability of medication-assisted treatment is a top priority of federal effort to combat opioid epidemic

The U.S. Food and Drug Administration today approved Probuphine, the first buprenorphine implant for the maintenance treatment of opioid dependence. Probuphine is designed to provide a constant, low-level dose of buprenorphine for six months in patients who are already stable on low-to-moderate doses of other forms of buprenorphine, as part of a complete treatment program.

Until today, buprenorphine for the treatment of opioid dependence was only approved as a pill or a film placed under the tongue or on the inside of a person’s cheek until it dissolved. While effective, a pill or film may be lost, forgotten or stolen. However, as an implant, Probuphine provides a new treatment option for people in recovery who may value the unique benefits of a six-month implant compared to other forms of buprenorphine, such as the possibility of improved patient convenience from not needing to take medication on a daily basis. An independent FDA advisory committee supported the approval of Probuphine in a meeting held earlier this year.

“Opioid abuse and addiction have taken a devastating toll on American families. We must do everything we can to make new, innovative treatment options available that can help patients regain control over their lives,” said FDA Commissioner Robert M. Califf, M.D. “Today’s approval provides the first-ever implantable option to support patients’ efforts to maintain treatment as part of their overall recovery program.”

Expanding the use and availability of medication-assisted treatment (MAT) options like buprenorphine is an important component of the FDA’s opioid action plan and one of three top priorities for the U.S. Department of Health and Human Services’ Opioid Initiative aimed at reducing prescription opioid and heroin related overdose, death and dependence.

Opioid dependence is the diagnostic term used for the more common concept, “addiction,” in the Probuphine clinical trials. Addiction is defined as a cluster of behavioral, cognitive and physiological phenomena that may include a strong desire to take the drug, difficulties in controlling drug use, persisting in drug use despite harmful consequences, a higher priority given to drug use than to other activities and obligations, as well as the possibility of the development of tolerance or development of physical dependence. Physical dependence is not the same as addiction. Newer diagnostic terminology uses the term “opioid use disorder,” which includes both milder forms of problematic opioid use as well as addiction.

MAT is a comprehensive approach that combines approved medications (currently, methadone, buprenorphine or naltrexone) with counseling and other behavioral therapies to treat patients with opioid use disorder. Regular adherence to MAT with buprenorphine reduces opioid withdrawal symptoms and the desire to use, without causing the cycle of highs and lows associated with opioid misuse or abuse. At sufficient doses, it also decreases the pleasurable effects of other opioids, making continued opioid abuse less attractive. According to the Substance Abuse and Mental Health Services Administration, patients receiving MAT for their opioid use disorder cut their risk of death from all causes in half.

“Scientific evidence suggests that maintenance treatment with these medications in the context of behavioral treatment and recovery support are more effective in the treatment of opioid use disorder than short-term detoxification programs aimed at abstinence,” said Nora Volkow, M.D., director of the National Institute on Drug Abuse at the National Institutes of Health. “This product will expand the treatment alternatives available to people suffering from an opioid use disorder.”

Probuphine should be used as part of a complete treatment program that includes counseling and psychosocial support. Probuphine consists of four, one-inch-long rods that are implanted under the skin on the inside of the upper arm and provide treatment for six months. Administering Probuphine requires specific training because it must be surgically inserted and removed. Only a health care provider who has completed the training and become certified through a restricted program called the Probuphine Risk Evaluation and Mitigation Strategy (REMS) program should insert and remove the implants. If further treatment is needed, new implants may be inserted in the opposite arm for one additional course of treatment. The FDA is requiring postmarketing studies to establish the safety and feasibility of placing the Probuphine implants for additional courses of treatment.

The safety and efficacy of Probuphine were demonstrated in a randomized clinical trial of adults who met the clinical criteria for opioid dependence and were considered stable after prior buprenorphine treatment. A response to MAT was measured by urine screening and self-reporting of illicit opioid use during the six month treatment period. Sixty-three percent of Probuphine-treated patients had no evidence of illicit opioid use throughout the six months of treatment – similar to the 64 percent of those who responded to sublingual (under the tongue) buprenorphine alone.

The most common side effects from treatment with Probuphine include implant-site pain, itching, and redness, as well as headache, depression, constipation, nausea, vomiting, back pain, toothache and oropharyngeal pain. The safety and efficacy of Probuphine have not been established in children or adolescents less than 16 years of age. Clinical studies of Probuphine did not include participants over the age of 65.

Probuphine has a boxed warning that provides important safety information for health care professionals, including a warning that insertion and removal of Probuphine are associated with the risk of implant migration, protrusion, expulsion and nerve damage resulting from the procedure. Probuphine must be prescribed and dispensed according to the Probuphine REMS program because of the risks of surgical complications and because of the risks of accidental overdose, misuse and abuse if an implant comes out or protrudes from the skin. As part of this program, Probuphine can only be prescribed and dispensed by health care providers who are certified with the REMS program and have completed live training, among other requirements.

Probuphine implants contain a significant amount of drug that can potentially be expelled or removed, resulting in the potential for accidental exposure or intentional misuse and abuse if the implant comes out of the skin. Patients should be seen during the first week after insertion and a visit schedule of no less than once-monthly is recommended for continued counseling and psychosocial support.

Probuphine is marketed by San Francisco-based Titan Pharmaceuticals Inc. and Braeburn Pharmaceuticals based in Princeton, New Jersey.

The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

Adverse effects

Common adverse drug reactions associated with the use of buprenorphine are similar to those of other opioids and include: nausea and vomiting, drowsiness, dizziness, headache, memory loss, cognitive and neural inhibition, perspiration, itchiness, dry mouth, miosis, orthostatic hypotension, male ejaculatory difficulty, decreased libido, andurinary retention. Constipation and CNS effects are seen less frequently than with morphine. Hepatic necrosis and hepatitis with jaundice have been reported with the use of buprenorphine, especially after intravenous injection of crushed tablets.^{[citation needed]}

Buprenorphine treatment carries the risk of causing psychological and or physical dependence. Buprenorphine has a slow onset, mild effect, and is very long acting with a half-life of 24 to 60 hours.^[66]

Unlike methadone, long term use of buprenorphine does not significantly suppress plasma testosterone levels in men and is therefore less frequently related to sexual side effects.^[67]

The most severe and serious adverse reaction associated with opioid use in general is respiratory depression, the mechanism behind fatal overdose. Buprenorphine behaves differently than other opioids in this respect, as it shows a ceiling effect for respiratory depression. Moreover, doubts about the antagonisation of the respiratory effects by naloxone have been disproved: Buprenorphine effects can be antagonised with a continuous infusion of naloxone.Concurrent use of buprenorphine with other CNS depressants (such as alcohol or benzodiazepines) is contraindicated as it may lead to fatal respiratory depression. Benzodiazepines, in recommended doses, are not contraindicated in individuals tolerant to either opioids or benzodiazepines.

There is another consequence of high-dose buprenorphine treatment that often goes overlooked by both physicians and patients when electing to use buprenorphine (in the form of Butrans transdermal patches) for chronic pain management. Because buprenorphine binds so tightly to μ‑opioid receptors in the central nervous system, it takes an extremely large dose of potent opioid pain medication to displace the buprenorphine from those receptors and provide additional pain relief in the acute setting. Patients on high-dose buprenorphine therapy may be unaffected by even very large doses of potent opioids such as fentanyl, morphine, or hydromorphone. Sufentanil (trade name Sufenta) is an extremely potent opioid analgesic (5 to 10 times more potent than fentanyl and 500 times more potent than morphine) for use in specific surgeries and surgery in highly opioid-tolerant or opioid-dependent patients that has a binding affinity that is high enough to theoretically break through a “buprenorphine blockade” to provide pain relief in patients taking high-dose buprenorphine. The problem is that sufentanil is frequently not available in the emergency room or acute care setting because of its highly specialized indications, thus making it very problematic for acute care practitioners to manage severe acute pain in persons already taking high-dose buprenorphine. It is also difficult to achieve acute opioid analgesia in persons using buprenorphine for opioid replacement therapy. Here, fentanyl, which has a higher affinity for μ‑opioid receptors, can successfully overcome buprenorphine blockade. Fentanyl is widely available in acute care settings

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Schizophrenia

Schizophrenia: What You Need to Know
Schizophrenia is a serious disorder which affects how a person thinks, feels and acts. Someone with schizophrenia may have difficulty distinguishing between what is real and what is imaginary; may be unresponsive or withdrawn; and may have difficulty expressing normal emotions in social situations.
Contrary to public perception, schizophrenia is not split personality or multiple personality. The vast majority of people with schizophrenia are not violent and do not pose a danger to others. Schizophrenia is not caused by childhood experiences, poor parenting or lack of willpower, nor are the symptoms identical for each person.
What Causes Schizophrenia?
The cause of schizophrenia is still unclear. Some theories about the cause of this disease include: genetics (heredity), biology (the imbalance in the brain’s chemistry); and/or possible viral infections and immune disorders.
Genetics (Heredity).

Scientists recognize that the disorder tends to run in families and that a person inherits a tendency to develop the disease. Schizophrenia may also be triggered by environmental events, such as viral infections or highly stressful situations or a combination of both.
Similar to some other genetically-related illnesses, schizophrenia appears when the body undergoes hormonal and physical changes, like those that occur during puberty in the teen and young adult years.
Chemistry.

Genetics help to determine how the brain uses certain chemicals. People with schizophrenia have a chemical imbalance of brain chemicals (serotonin and dopamine) which are neurotransmitters. These neurotransmitters allow nerve cells in the brain to send messages to each other. The imbalance of these chemicals affects the way a person’s brain reacts to stimuli–which explains why a person with schizophrenia may be overwhelmed by sensory information (loud music or bright lights) which other people can easily handle. This problem in processing different sounds, sights, smells and tastes can also lead to hallucinations or delusions.
What are the Early Warning Signs of Schizophrenia?
The signs of schizophrenia are different for everyone. Symptoms may develop slowly over months or years, or may appear very abruptly. The disease may come and go in cycles of relapse and remission.

طبائع الاستبداد- الكواكبي

tabae3

Men’s Health – Age and stay healthy

mens-health-50-and-forward

Understanding Depression

understanding depression

FDA Warns About New Impulse-control Problems

Aripiprazole (Abilify, Abilify Maintena, Aristada): Drug Safety Communication – FDA Warns About New Impulse-control Problems

[Posted 05/03/2016]

AUDIENCE: Psychiatry, Internal Medicine, Patient

ISSUE: FDA is warning that compulsive or uncontrollable urges to gamble, binge eat, shop, and have sex have been reported with the use of the antipsychotic drug aripiprazole (Abilify, Abilify Maintena, Aristada, and generics). These uncontrollable urges were reported to have stopped when the medicine was discontinued or the dose was reduced. These impulse-control problems are rare, but they may result in harm to the patient and others if not recognized.

Although pathological gambling is listed as a reported side effect in the current aripiprazole drug labels, this description does not entirely reflect the nature of the impulse-control risk FDA identified. In addition, FDA has become aware of other compulsive behaviors associated with aripiprazole, such as compulsive eating, shopping, and sexual actions. These compulsive behaviors can affect anyone who is taking the medicine. As a result, FDA is adding new warnings about all of these compulsive behaviors to the drug labels and the patient Medication Guides for all aripiprazole products.

See the FDA Drug Safety Communication for additional information, including a Data Summary.

BACKGROUND: Aripiprazole is used to treat certain mental disorders, including schizophrenia, bipolar disorder, Tourette’s disorder, and irritability associated with autistic disorder. It may also be used in combination with antidepressants to treat depression. Aripiprazole can decrease hallucinations and other psychotic symptoms such as disorganized thinking. It can stabilize mood, improve depression, and decrease the tics of Tourette’s disorder.

RECOMMENDATION: Health care professionals should make patients and caregivers aware of the risk of these uncontrollable urges when prescribing aripiprazole, and specifically ask patients about any new or increasing urges while they are being treated with aripiprazole. Closely monitor for new or worsening uncontrollable urges in patients at higher risk for impulse-control problems. These include those with a personal or family history of obsessive-compulsive disorder, impulse-control disorder, bipolar disorder, impulsive personality, alcoholism, drug abuse, or other addictive behaviors. Consider reducing the dose or stopping the medicine if such urges develop.

Patients and caregivers should be alert for uncontrollable and excessive urges and behaviors while taking aripiprazole. It is important to talk with a health care professional as soon as possible if you or a family member experiences any of these uncontrollable urges, in order to prevent or limit possible harm. Patients should not suddenly stop taking their aripiprazole medicine without first talking to their health care professional.

See theFDA Drug Safety Communication for additional information for patients, caregivers, and health care professionals.

Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA’s MedWatch Safety Information and Adverse Event Reporting Program:

Complete and submit the report Online: www.fda.gov/MedWatch/report
Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178

[05/03/2016 – Drug Safety Communication – FDA]

مشكلات الاطفال السلوكية

Behavioral

Asperger_Scale

Asperger_scale_aabic

How to visualize it ?

The technique used to win the game, get rich, and fight illness…visualization. Visualization is a cognitive tool accessing imagination to realize all aspects of an object, action or outcome. This may include recreating a mental sensory experience of sound, sight, smell, taste, and touch.

In psychological practice, visualization is often used to mentally rehearse an action or bring a patient to a state of relaxation. Dr. Cathryne Maciolek, a D.C. area psychotherapist, uses visualization in her clinical practice. She quotes Rosabeth Moss Kanter to illustrate the power of the technique, “A vision is not just a picture of what could be; it is an appeal to our better selves, a call to become something more.” She explains that visualization is a means of control in an uncontrollable situation.

As a supplement to mental visualization, concrete expressions of visualization, such as vision boards that incorporate pictures cut from magazines, phrases, and drawings often in a collage format, and small objects, such as a trinket help symbolize the vision. In 1987, when Jim Carey was only a struggling comic, he visualized a successful and lucrative career. To make his vision concrete, he wrote himself a check for $10 million for “acting services rendered” dated for Thanksgiving of 1995, which he placed in his wallet. By 1995, Carey was already an established comedic actor commanding far more than $10 million per picture.

Dr. Maciolek further elaborates on the power of visualization and the benefit of concrete objects to represent them. With a patient experiencing depression with suicidal ideation, Dr. Maciolek created a treatment plan including setting future positive goals. Although he had initial difficulty imagining purchasing a house, getting married, and starting a family, with the help of pictures from magazines, Dr. Maciolek’s patient could literally hold onto his dream. “He carried these images of a woman, a home, and children in his wallet. During times he felt down, he would take the pictures out of his wallet as a concrete reminder of what he wanted for his future.”

For patients battling anxiety, Dr. Maciolek uses visualization to create “mental vacations.” This technique involves imagining a place that is calm and comforting. With one patient who suffered from severe anxiety, using pure visualization to imagine a serene vacation spot was almost impossible. With the aid of a concrete visual, a picture of the spot depicted on poster board, the image calmed the patient when she was feeling anxious.

Dr. Maciolek states that “Visualization is not only used to cope with psychological diagnoses such as anxiety and depression, but it can be used in our everyday lives.” She goes on to explain various uses of visualization, such as using imagery before personal or professional interaction when one can imagine successfully giving a presentation or taking an exam. When involved in sports, one can mentally practice before a game, imagining catching a football or making a goal. When preparing for a difficult medical procedure, one can visualize the result of a successful outcome. Using concrete objects can increase visualization effectiveness. She suggests using a vision board with motivating pictures of healthy foods, people working out, and inspirational statements for weight loss. When trying to decrease negative thoughts, she suggests writing the thoughts or finding images of the thoughts, and placing the items in a box in order to contain them.

Whether in therapy or in your everyday life, using visualization is an important tool to improve all areas. In addition to using mental rehearsals, vision boards, and representative objects, this would not be the Psychology of Dress without the mention of using the contents of the wardrobe. As both a psychologist and fashion advisor, I have used clothing as an integral part of the visualization process. Whether with an employee striving for a promotion who I advise to “dress the part” or a worn out mom experiencing depression who I suggest taking “me time” to wear something that makes her feel fabulous, altering the external can facilitate internal change.

Tips:
- Create a mood board with colors, textures and shapes that excite you.
- Keep something visual close by, such as images of people succeeding in areas relating to your goal, or a beloved dress on the back of a door.
- Acknowledge your goal milestones regularly by treating yourself, even with small rewards. For example, if you are on a weight loss program, treat yourself to a new garment at the end of each month when you stay on track. Keep a picture of the garment until you are able to purchase it.
- Create a new habit by linking the desired change (your goal) to something already in your routine (a trigger that will remind you to do it). If you goal is to increase yourworkplace confidence, tweak your existing routine of daily dress. Try using small wardrobe changes – perhaps a new tie color or an accessory to incrementally change your work wardrobe. Note how you feel.
- Visualize yourself achieving what you’re aspiring for. Visualize each detail, mentally bookmark it, and note how you look, feel, dress, move, sound. Revisit your visualization often. Begin integrating the relevant garments or colors into your repertoire to support that vision.
Whether using imagery, vision boards, small objects, or wardrobe changes, visualization is a powerful tool for goal achievement. The process primes the brain to look for cues in the environment that connect to the vision, such as a contact person, website, television show, or ad. These connections move the person to action, such as making a phone call, posting a comment, going for the audition, or creating a webpage. If you have something you desire, use the power of the mind to facilitate the realization. Recall the story of the man who prays and prays to win the lottery. After years pass without a lottery win, the man confronts God and asks why he has not won. God says “You never bought a ticket!” Once you have a clear conceptualization of what you want act on it! In a year’s time, do not be shocked that you have accomplished what was once “only a dream.”

Why we should wake up early?

1. You’ll have time to discover the hidden you

Woman with eyes closed, hands behind head — meditate

Many people don’t achieve their goals just because of a lack of focus. It’s easy to get distracted from your life goals throughout the day if you don’t start it thinking about what you have to do urgently.
As is well known, our brain works more effectively during the first half of the day. Use this time to take your life under control and don’t let your emotions rule.
2. You’ll have time to schedule your day

Hands holding and point on digi — tablet

Early birds have the opportunity to plan their day in advance before going to work. The earlier you have your day’s plan done, the more effectively and productively you’ll spend the time.
It’s counterproductive to map out your next day in the evening. Drawing up plans is not the best idea when your brain has gone stale and can only think about getting rest.
3. Morning is a perfect time to work on self-improvement

Who said you have to rush to the office straight after waking up? Many people complain that they don’t have enough time for family, entertainment or the gym.
If you’re awake at 6 in the morning, you’ll have a couple of hours to get to the gym before the workday starts. When you work out in the mornings, your body is sated with endorphins. These are hormones that are discharged during physical activity and give us a feeling of joy and euphoria. The endorphins you get in the morning are usually enough to make you energetic and cheerful for the rest of the day.
4. You’ll start eating breakfast

Throughout your life, you often hear that breakfast is the most important meal of the day. If you are awake a couple hours before going to work, you won’t miss it.
A study by John Hopkins Bloomberg School of Public Health shows that the habit to have a full breakfast has an extremely important positive meaning for your health. Just as your car needs gas to go, your body needs food to function properly, especially in the mornings.
5. Successful people already do so!

A New York Magazine article about Jack Dorsey, the founder of Twitter, said that he starts his day at 5:30 a.m. Dorsey uses this time before the workday for meditation and a 10-kilometer run.
Tim Cook, the CEO of Apple, starts answering his partners’ e-mails at 4:30 every morning.
Richard Branson, the founder of the Virgin Group, is also an early morning enthusiast. In his interviews with Business Insider, he said that he wakes up at 5:45 a.m. and gets to work right away. He works first at his computer, and then he eats breakfast.
6. You’ll be two steps ahead of everyone

As researchers show, the habit of waking up early can help you unleash your creative potential. Moreover, it develops your confidence: you start to work while all your competitors are asleep.
I’ve learned to settle the most unpleasant matters before 8 a.m. This habit allows me to live the whole day after that with a high level of energy and the feeling that my duty has been done. The habit of doing the uncomfortable things early in the morning reduces my levels of stress and anxiety.
Also, if you can train yourself to wake up two and a half hours earlier than usual, you get the benefit of 150 extra minutes per day, which is 17 and a half hours per week, more than 70 hours per month, and 840 hours per year. The choice is yours.